SlideShare ist ein Scribd-Unternehmen logo
1 von 20
STOP Sepsis 6-hour  Strategies to  Timely  Obviate the  Progression of Sepsis 6-hour STOP Bundle summarized by sun yaicheng http://decode-medicine.blogspot.com/
Early Goal-Directed Therapy in the Treatment of Severe Sepsis and Septic Shock Rivers E.  N Engl J Med 2001;345:1368-77.
Sepsis SIRS Severe Sepsis Septic Shock Sepsis SIRS Severe Sepsis Septic Shock Systemic Inflammatory Response Syndrome  ,[object Object]
HR > 90
RR > 20 or PCO2 < 32
WBC < 4K or > 12K or bands > 10%Bone et al. Chest 1992;101:1644
SIRS Severe Sepsis Septic Shock Sepsis SIRS with Infection Bone et al. Chest 1992;101:1644
SIRS Severe Sepsis Septic Shock Sepsis Sepsis plus Organ Dysfunction ,[object Object]
Elevated INR (DIC)
Altered Mental Status (GCS <12)
Elevated Lactate (>4)
Hypotension that responds to fluidBone et al. Chest 1992;101:1644
SIRS Severe Sepsis Septic Shock Sepsis Severe Sepsis and Hypotension ,[object Object],Bone et al. Chest 1992;101:1644
Criteria to initiate the bundle SIRS plus source of infection plus a ,[object Object]
Lactate > 4 mmol/L
Organ dysfunctionSTOP SEPSIS SCCM 34th Critical Care Congress: Abstract 44. Presented Jan. 17,2005.
STOP Bundle Strategies ,[object Object]

Weitere ähnliche Inhalte

Was ist angesagt?

Anesthetic considerations for spinal surgery
Anesthetic considerations for spinal surgeryAnesthetic considerations for spinal surgery
Anesthetic considerations for spinal surgery
Dhritiman Chakrabarti
 
Pulmonary Embolism
Pulmonary Embolism	Pulmonary Embolism
Pulmonary Embolism
Khalid
 
Severe Sepsis & Septic Shock
Severe Sepsis & Septic ShockSevere Sepsis & Septic Shock
Severe Sepsis & Septic Shock
Andrew Ferguson
 

Was ist angesagt? (20)

Sequential Organ Failure Assessment (SOFA) Score
Sequential Organ Failure Assessment (SOFA) ScoreSequential Organ Failure Assessment (SOFA) Score
Sequential Organ Failure Assessment (SOFA) Score
 
Septic shock management (1)
Septic shock management (1)Septic shock management (1)
Septic shock management (1)
 
sepsis SSC 2021 Updates Ventilation and additional therapy
sepsis SSC 2021 Updates Ventilation and additional therapysepsis SSC 2021 Updates Ventilation and additional therapy
sepsis SSC 2021 Updates Ventilation and additional therapy
 
Rapid sequence intubation
Rapid sequence intubationRapid sequence intubation
Rapid sequence intubation
 
ATLS 10th Edition Compendium of Change
ATLS 10th Edition Compendium of ChangeATLS 10th Edition Compendium of Change
ATLS 10th Edition Compendium of Change
 
Sepsis
SepsisSepsis
Sepsis
 
Anesthetic considerations for spinal surgery
Anesthetic considerations for spinal surgeryAnesthetic considerations for spinal surgery
Anesthetic considerations for spinal surgery
 
What is new in sepsis
What is new in sepsisWhat is new in sepsis
What is new in sepsis
 
Sepsis, SIRS & Septic Shock
Sepsis, SIRS & Septic ShockSepsis, SIRS & Septic Shock
Sepsis, SIRS & Septic Shock
 
Management of sepsis and septic shock
Management of sepsis and septic shockManagement of sepsis and septic shock
Management of sepsis and septic shock
 
Anaesthesia for LSCS
Anaesthesia for LSCSAnaesthesia for LSCS
Anaesthesia for LSCS
 
Sepsis
SepsisSepsis
Sepsis
 
Sepsis
SepsisSepsis
Sepsis
 
Sodium correction formula
Sodium correction formulaSodium correction formula
Sodium correction formula
 
Pulmonary Embolism
Pulmonary Embolism	Pulmonary Embolism
Pulmonary Embolism
 
Rapid Sequence Induction & Intubation
Rapid Sequence Induction & Intubation Rapid Sequence Induction & Intubation
Rapid Sequence Induction & Intubation
 
ARDS - Diagnosis and Management
ARDS - Diagnosis and ManagementARDS - Diagnosis and Management
ARDS - Diagnosis and Management
 
ventilator Associated Pneumonia -By Dr.Tinku Joseph
ventilator Associated Pneumonia -By Dr.Tinku Josephventilator Associated Pneumonia -By Dr.Tinku Joseph
ventilator Associated Pneumonia -By Dr.Tinku Joseph
 
Severe Sepsis & Septic Shock
Severe Sepsis & Septic ShockSevere Sepsis & Septic Shock
Severe Sepsis & Septic Shock
 
Sepsis and septic shock
Sepsis and septic shockSepsis and septic shock
Sepsis and septic shock
 

Andere mochten auch

Journal club edgt 2016 (1)
Journal club edgt 2016 (1)Journal club edgt 2016 (1)
Journal club edgt 2016 (1)
sath_gasclub
 
M.I.C.3-方瑞雯醫師
M.I.C.3-方瑞雯醫師M.I.C.3-方瑞雯醫師
M.I.C.3-方瑞雯醫師
PanSci
 
M.I.C.3-黎煥中組長
M.I.C.3-黎煥中組長M.I.C.3-黎煥中組長
M.I.C.3-黎煥中組長
PanSci
 

Andere mochten auch (20)

Sepsis
SepsisSepsis
Sepsis
 
MMUH ICU ED teaching sepsis
MMUH ICU ED teaching sepsisMMUH ICU ED teaching sepsis
MMUH ICU ED teaching sepsis
 
Journal club edgt 2016 (1)
Journal club edgt 2016 (1)Journal club edgt 2016 (1)
Journal club edgt 2016 (1)
 
M.I.C.3-方瑞雯醫師
M.I.C.3-方瑞雯醫師M.I.C.3-方瑞雯醫師
M.I.C.3-方瑞雯醫師
 
M.I.C.3-黎煥中組長
M.I.C.3-黎煥中組長M.I.C.3-黎煥中組長
M.I.C.3-黎煥中組長
 
Sepsis
SepsisSepsis
Sepsis
 
台灣醫療現狀
台灣醫療現狀台灣醫療現狀
台灣醫療現狀
 
Sepsis and early goal directed therapy
Sepsis and early goal directed therapySepsis and early goal directed therapy
Sepsis and early goal directed therapy
 
台灣急診醫療糾紛現狀
台灣急診醫療糾紛現狀台灣急診醫療糾紛現狀
台灣急診醫療糾紛現狀
 
Community- Acquired Pneumonia
Community- Acquired PneumoniaCommunity- Acquired Pneumonia
Community- Acquired Pneumonia
 
Early Goal Directed Therapy in 2015
Early Goal Directed Therapy in 2015Early Goal Directed Therapy in 2015
Early Goal Directed Therapy in 2015
 
Surviving Sepsis Guidelines 2012
Surviving Sepsis Guidelines 2012Surviving Sepsis Guidelines 2012
Surviving Sepsis Guidelines 2012
 
Management of Skin and Soft Tissue Infections: IDSA Guideline 2014
Management of Skin and Soft Tissue Infections: IDSA Guideline 2014Management of Skin and Soft Tissue Infections: IDSA Guideline 2014
Management of Skin and Soft Tissue Infections: IDSA Guideline 2014
 
Sepsis
SepsisSepsis
Sepsis
 
Intra-abdominal Infection Guidelines 2010
Intra-abdominal Infection Guidelines 2010Intra-abdominal Infection Guidelines 2010
Intra-abdominal Infection Guidelines 2010
 
2015 AHA CPR & ECC 更新重點提要
2015 AHA CPR & ECC 更新重點提要2015 AHA CPR & ECC 更新重點提要
2015 AHA CPR & ECC 更新重點提要
 
Top 10 Myths Regarding the Diagnosis and Treatment of UTI
Top 10 Myths Regarding the Diagnosis and Treatment of UTITop 10 Myths Regarding the Diagnosis and Treatment of UTI
Top 10 Myths Regarding the Diagnosis and Treatment of UTI
 
ACEP Policy for Fever Infants and Children Younger than 2 Years of Age in ED
ACEP Policy for Fever Infants and Children Younger than 2 Years of Age in EDACEP Policy for Fever Infants and Children Younger than 2 Years of Age in ED
ACEP Policy for Fever Infants and Children Younger than 2 Years of Age in ED
 
Sepsis 2016
Sepsis 2016 Sepsis 2016
Sepsis 2016
 
Surviving Sepsis Guidelines 2016
Surviving Sepsis Guidelines 2016Surviving Sepsis Guidelines 2016
Surviving Sepsis Guidelines 2016
 

Ähnlich wie The STOP Sepsis Bundle

Optimzing sepsis management
Optimzing sepsis managementOptimzing sepsis management
Optimzing sepsis management
EM OMSB
 
Case presentation
Case presentation  Case presentation
Case presentation
EM OMSB
 
Sepsisandseveresepsis
SepsisandseveresepsisSepsisandseveresepsis
Sepsisandseveresepsis
davidjmock
 
7.疼痛治療新紀元Final handout
7.疼痛治療新紀元Final handout 7.疼痛治療新紀元Final handout
7.疼痛治療新紀元Final handout
netnk
 

Ähnlich wie The STOP Sepsis Bundle (20)

Sepsis
SepsisSepsis
Sepsis
 
Rheumatic Fever
Rheumatic FeverRheumatic Fever
Rheumatic Fever
 
CORTICUS
CORTICUSCORTICUS
CORTICUS
 
ACTEP2014: Sepsis management has anything change
ACTEP2014: Sepsis management has anything change ACTEP2014: Sepsis management has anything change
ACTEP2014: Sepsis management has anything change
 
Pediatric Case Study
Pediatric Case StudyPediatric Case Study
Pediatric Case Study
 
Optimzing sepsis management
Optimzing sepsis managementOptimzing sepsis management
Optimzing sepsis management
 
Sepsis controversies f
Sepsis  controversies  fSepsis  controversies  f
Sepsis controversies f
 
Case presentation
Case presentation  Case presentation
Case presentation
 
Serelaxin in acute heart failure
Serelaxin in acute heart failureSerelaxin in acute heart failure
Serelaxin in acute heart failure
 
Power point oke rina ramayani aki definition
Power point  oke rina ramayani aki definitionPower point  oke rina ramayani aki definition
Power point oke rina ramayani aki definition
 
Biliary pancreatitis
Biliary pancreatitisBiliary pancreatitis
Biliary pancreatitis
 
Pericarditis
PericarditisPericarditis
Pericarditis
 
Salon a 13 kasim 11.30 12.45 emre karakoç-i̇ng
Salon a 13 kasim 11.30   12.45 emre karakoç-i̇ngSalon a 13 kasim 11.30   12.45 emre karakoç-i̇ng
Salon a 13 kasim 11.30 12.45 emre karakoç-i̇ng
 
PPI and CVD.pptx
PPI and CVD.pptxPPI and CVD.pptx
PPI and CVD.pptx
 
Sepsis in the ED
Sepsis in the EDSepsis in the ED
Sepsis in the ED
 
Sepsisandseveresepsis
SepsisandseveresepsisSepsisandseveresepsis
Sepsisandseveresepsis
 
Critical Conversations on Atrial Fibrillation: A MasterClass Series
Critical Conversations on Atrial Fibrillation: A MasterClass SeriesCritical Conversations on Atrial Fibrillation: A MasterClass Series
Critical Conversations on Atrial Fibrillation: A MasterClass Series
 
Heat stroke and rhabdomyolysis 2017 final
Heat stroke and rhabdomyolysis 2017 finalHeat stroke and rhabdomyolysis 2017 final
Heat stroke and rhabdomyolysis 2017 final
 
7.疼痛治療新紀元Final handout
7.疼痛治療新紀元Final handout 7.疼痛治療新紀元Final handout
7.疼痛治療新紀元Final handout
 
Emergency medicine research
Emergency medicine researchEmergency medicine research
Emergency medicine research
 

Mehr von Sun Yai-Cheng

Mehr von Sun Yai-Cheng (20)

COVID-19 (Coronavirus disease 2019), part 2
COVID-19 (Coronavirus disease 2019), part 2COVID-19 (Coronavirus disease 2019), part 2
COVID-19 (Coronavirus disease 2019), part 2
 
COVID-19 (Coronavirus disease 2019) update
COVID-19 (Coronavirus disease 2019) updateCOVID-19 (Coronavirus disease 2019) update
COVID-19 (Coronavirus disease 2019) update
 
Initial Care of the Severely Injured Patient
Initial Care of the Severely Injured PatientInitial Care of the Severely Injured Patient
Initial Care of the Severely Injured Patient
 
Management of Heart Failure in ED
Management of Heart Failure in EDManagement of Heart Failure in ED
Management of Heart Failure in ED
 
2018 Stroke Guidelines
2018 Stroke Guidelines2018 Stroke Guidelines
2018 Stroke Guidelines
 
DAWN and DEFUSE 3 trial
DAWN and DEFUSE 3 trialDAWN and DEFUSE 3 trial
DAWN and DEFUSE 3 trial
 
The European Guideline on Management of Major Bleeding and Coagulopathy Follo...
The European Guideline on Management of Major Bleeding and Coagulopathy Follo...The European Guideline on Management of Major Bleeding and Coagulopathy Follo...
The European Guideline on Management of Major Bleeding and Coagulopathy Follo...
 
VBG or ABG analysis in Emergency Care?
VBG or ABG analysis in Emergency Care?VBG or ABG analysis in Emergency Care?
VBG or ABG analysis in Emergency Care?
 
Focused Cardiac Ultrasound
Focused Cardiac UltrasoundFocused Cardiac Ultrasound
Focused Cardiac Ultrasound
 
ACLS 2015
ACLS 2015ACLS 2015
ACLS 2015
 
Post–Cardiac Arrest Care
Post–Cardiac Arrest CarePost–Cardiac Arrest Care
Post–Cardiac Arrest Care
 
2015 AHA/ASA Focused Update Guidelines for Acute Ischemic Stroke Regarding En...
2015 AHA/ASA Focused Update Guidelines for Acute Ischemic Stroke Regarding En...2015 AHA/ASA Focused Update Guidelines for Acute Ischemic Stroke Regarding En...
2015 AHA/ASA Focused Update Guidelines for Acute Ischemic Stroke Regarding En...
 
Best Mobile Medical Apps in ED
Best Mobile Medical Apps in EDBest Mobile Medical Apps in ED
Best Mobile Medical Apps in ED
 
Use of tPA for the Management of Acute Ischemic Stroke in the ED: ACEP Policy
Use of tPA for the Management of Acute Ischemic Stroke in the ED: ACEP PolicyUse of tPA for the Management of Acute Ischemic Stroke in the ED: ACEP Policy
Use of tPA for the Management of Acute Ischemic Stroke in the ED: ACEP Policy
 
Evaluation and Management of Acute Aortic Dissection: ACEP Policy
Evaluation and Management of  Acute Aortic Dissection: ACEP PolicyEvaluation and Management of  Acute Aortic Dissection: ACEP Policy
Evaluation and Management of Acute Aortic Dissection: ACEP Policy
 
C-Spine Collar Clearance In The Obtunded Adult Blunt Trauma Patient
C-Spine Collar Clearance In The Obtunded Adult Blunt Trauma PatientC-Spine Collar Clearance In The Obtunded Adult Blunt Trauma Patient
C-Spine Collar Clearance In The Obtunded Adult Blunt Trauma Patient
 
ASA Guidelines for Management of the Difficult Airway
ASA Guidelines for Management of the Difficult AirwayASA Guidelines for Management of the Difficult Airway
ASA Guidelines for Management of the Difficult Airway
 
2014 AHA/ACC/HRS Atrial Fibrillation Guideline
2014 AHA/ACC/HRS Atrial Fibrillation Guideline2014 AHA/ACC/HRS Atrial Fibrillation Guideline
2014 AHA/ACC/HRS Atrial Fibrillation Guideline
 
Non–ST-Elevation–ACS 2014 Guidelines
Non–ST-Elevation–ACS 2014 GuidelinesNon–ST-Elevation–ACS 2014 Guidelines
Non–ST-Elevation–ACS 2014 Guidelines
 
Management of Seizures in ED
Management of Seizures in EDManagement of Seizures in ED
Management of Seizures in ED
 

Kürzlich hochgeladen

💚Chandigarh Call Girls Service 💯Piya 📲🔝8868886958🔝Call Girls In Chandigarh No...
💚Chandigarh Call Girls Service 💯Piya 📲🔝8868886958🔝Call Girls In Chandigarh No...💚Chandigarh Call Girls Service 💯Piya 📲🔝8868886958🔝Call Girls In Chandigarh No...
💚Chandigarh Call Girls Service 💯Piya 📲🔝8868886958🔝Call Girls In Chandigarh No...
Sheetaleventcompany
 
Call Girl In Indore 📞9235973566📞 Just📲 Call Inaaya Indore Call Girls Service ...
Call Girl In Indore 📞9235973566📞 Just📲 Call Inaaya Indore Call Girls Service ...Call Girl In Indore 📞9235973566📞 Just📲 Call Inaaya Indore Call Girls Service ...
Call Girl In Indore 📞9235973566📞 Just📲 Call Inaaya Indore Call Girls Service ...
Sheetaleventcompany
 
Gorgeous Call Girls Dehradun {8854095900} ❤️VVIP ROCKY Call Girls in Dehradun...
Gorgeous Call Girls Dehradun {8854095900} ❤️VVIP ROCKY Call Girls in Dehradun...Gorgeous Call Girls Dehradun {8854095900} ❤️VVIP ROCKY Call Girls in Dehradun...
Gorgeous Call Girls Dehradun {8854095900} ❤️VVIP ROCKY Call Girls in Dehradun...
Sheetaleventcompany
 
💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...
💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...
💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...
Sheetaleventcompany
 
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
rajnisinghkjn
 
Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...
Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...
Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...
amritaverma53
 

Kürzlich hochgeladen (20)

💚Chandigarh Call Girls Service 💯Piya 📲🔝8868886958🔝Call Girls In Chandigarh No...
💚Chandigarh Call Girls Service 💯Piya 📲🔝8868886958🔝Call Girls In Chandigarh No...💚Chandigarh Call Girls Service 💯Piya 📲🔝8868886958🔝Call Girls In Chandigarh No...
💚Chandigarh Call Girls Service 💯Piya 📲🔝8868886958🔝Call Girls In Chandigarh No...
 
Exclusive Call Girls Bangalore {7304373326} ❤️VVIP POOJA Call Girls in Bangal...
Exclusive Call Girls Bangalore {7304373326} ❤️VVIP POOJA Call Girls in Bangal...Exclusive Call Girls Bangalore {7304373326} ❤️VVIP POOJA Call Girls in Bangal...
Exclusive Call Girls Bangalore {7304373326} ❤️VVIP POOJA Call Girls in Bangal...
 
Call Girls Kathua Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Kathua Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Kathua Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Kathua Just Call 8250077686 Top Class Call Girl Service Available
 
Call Girl In Indore 📞9235973566📞 Just📲 Call Inaaya Indore Call Girls Service ...
Call Girl In Indore 📞9235973566📞 Just📲 Call Inaaya Indore Call Girls Service ...Call Girl In Indore 📞9235973566📞 Just📲 Call Inaaya Indore Call Girls Service ...
Call Girl In Indore 📞9235973566📞 Just📲 Call Inaaya Indore Call Girls Service ...
 
ANATOMY AND PHYSIOLOGY OF REPRODUCTIVE SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF REPRODUCTIVE SYSTEM.pptxANATOMY AND PHYSIOLOGY OF REPRODUCTIVE SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF REPRODUCTIVE SYSTEM.pptx
 
Chennai ❣️ Call Girl 6378878445 Call Girls in Chennai Escort service book now
Chennai ❣️ Call Girl 6378878445 Call Girls in Chennai Escort service book nowChennai ❣️ Call Girl 6378878445 Call Girls in Chennai Escort service book now
Chennai ❣️ Call Girl 6378878445 Call Girls in Chennai Escort service book now
 
❤️Call Girl Service In Chandigarh☎️9814379184☎️ Call Girl in Chandigarh☎️ Cha...
❤️Call Girl Service In Chandigarh☎️9814379184☎️ Call Girl in Chandigarh☎️ Cha...❤️Call Girl Service In Chandigarh☎️9814379184☎️ Call Girl in Chandigarh☎️ Cha...
❤️Call Girl Service In Chandigarh☎️9814379184☎️ Call Girl in Chandigarh☎️ Cha...
 
Gorgeous Call Girls Dehradun {8854095900} ❤️VVIP ROCKY Call Girls in Dehradun...
Gorgeous Call Girls Dehradun {8854095900} ❤️VVIP ROCKY Call Girls in Dehradun...Gorgeous Call Girls Dehradun {8854095900} ❤️VVIP ROCKY Call Girls in Dehradun...
Gorgeous Call Girls Dehradun {8854095900} ❤️VVIP ROCKY Call Girls in Dehradun...
 
Cheap Rate Call Girls Bangalore {9179660964} ❤️VVIP BEBO Call Girls in Bangal...
Cheap Rate Call Girls Bangalore {9179660964} ❤️VVIP BEBO Call Girls in Bangal...Cheap Rate Call Girls Bangalore {9179660964} ❤️VVIP BEBO Call Girls in Bangal...
Cheap Rate Call Girls Bangalore {9179660964} ❤️VVIP BEBO Call Girls in Bangal...
 
💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...
💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...
💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...
 
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
 
Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...
Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...
Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...
 
ANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptxANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptx
 
Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...
Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...
Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...
 
💰Call Girl In Bangalore☎️63788-78445💰 Call Girl service in Bangalore☎️Bangalo...
💰Call Girl In Bangalore☎️63788-78445💰 Call Girl service in Bangalore☎️Bangalo...💰Call Girl In Bangalore☎️63788-78445💰 Call Girl service in Bangalore☎️Bangalo...
💰Call Girl In Bangalore☎️63788-78445💰 Call Girl service in Bangalore☎️Bangalo...
 
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...
 
Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...
Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...
Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...
 
Call 8250092165 Patna Call Girls ₹4.5k Cash Payment With Room Delivery
Call 8250092165 Patna Call Girls ₹4.5k Cash Payment With Room DeliveryCall 8250092165 Patna Call Girls ₹4.5k Cash Payment With Room Delivery
Call 8250092165 Patna Call Girls ₹4.5k Cash Payment With Room Delivery
 
tongue disease lecture Dr Assadawy legacy
tongue disease lecture Dr Assadawy legacytongue disease lecture Dr Assadawy legacy
tongue disease lecture Dr Assadawy legacy
 
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service AvailableCall Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
 

The STOP Sepsis Bundle